Position Description: Welcome to one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.SM The Subrogation Analyst handles information about patient services and how the services are paid by investigating and pursuing recoveries through contact with various parties. The analyst manages subrogation files, negotiates settlements, and ensures adherence to compliance policies.Positions in this function are responsible for investigating, recovering and resolving all types of claims as well as recovery and resolution for health plans, commercial customers and government entities. May include initiating telephone calls to members, providers and other insurance companies to gather coordination of benefits data. Investigate and pursue recoveries and payables on subrogation claims and file management. Process recovery on claims. Ensure adherence to state and federal compliance policies, reimbursement policies and contract compliance. May conduct contestable investigations to review medical history. May monitor large claims including transplant cases. Primary Responsibilities: Prepare final lien reports to include reviewing claims to relate/unrelate based on ICD10 codes and accident details; Investigate loss for liability and available insurance coverage; Pursue recovery of lien from member attorney and/or insurance carriers; Negotiate settlements with member attorney and/or insurance carriers; Take incoming phone calls from member, attorneys, insurance companies and respond to their questions and requests.
Required Qualifications: High School Diploma / GED or higher 1+ years of experience managing claims, legal matters, and / or performing investigations 3+ years of Customer Service experience analyzing and solving customer's problems Experience with Microsoft Excel to create, save, and document spreadsheets Experience with computer and Windows PC applicationsPreferred Qualifications:Undergraduate degree or higher Experience using claims platforms such as UNET, Pulse, NICE, FACETS, Diamond, etc. Experience working in the Healthcare Industry 2+ years of claims/subrogation experience with health insurance, property & casualty insurance and/or a law firms 1+ years of prior negotiation experience Soft Skills:Excellent communication, both verbal and written, with strong presentation skills; Strong analytical, problem solving, and decision-making skills; ability to exercise good judgment; Open to change and new information; ability to adapt behavior and work methods to changing organization and integrate best practices into the subrogation recovery process; Demonstrate ability to work effectively, independently and within a collaborative team oriented environment; Display confidence and the ability to stand your ground in contested situations.Physical Requirements and Work Environment:Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activityCareers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SMDiversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or _expression, marital status, genetic information, or any other characteristic protected by law. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Keywords:managing claims, lega, UNET, Pulse, NICE, FACETS
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.